Section 4.5: Emotional Distress/Mental Health Crisis/Suicide Ideation

For whatever reason, we know that as a Resident Assistant you may interact with students who are experiencing some form of a crisis situation.  This could be an emotional concern, something related to mental health, or even be expressed as suicidal ideation.

• Emotional Distress - emotional distress is generally brought on by a specific event that causes the person's emotions to become overwhelmed.  This type of distress is generally temporary and the person will generally start to feel better again once they regain control over their emotions or as they learn to cope with the situation as time passes.  

• Mental Health Crisis - mental health crises are situations in which a mental health disorder, such as (but not limited to) anxiety or depression, manifests itself in a way that a person can either not care for themselves, or that they become a risk to themselves or others.

• Suicidal Ideation - situations where a person experiencing distress or crisis begins to wish they weren't alive or in which they have the intent and a plan to take their own life.

Some common warning signs a person may be in distress or crisis include include:

• Withdrawal from social interaction

• Loss of interest in usual activities

• Inability to do typical tasks, such as getting out of bed, personal hygiene, or going to class

• Reckless or aggressive behaviors

• Signs of sadness, hopelessness, or irritability

• Sudden shifts in mood

• Changes in appetite, weight, behaviors, or sleep patterns

• Loss of energy

• Frequent negative self talk

• Talking, writing, or joking about death or thoughts of suicide

• Giving away personal possessions

If you are interacting with a student and become aware they may be in distress, in crisis, or are considering attempting suicide, the most important thing to do is to maintain a presence of calm and try to provide help to the student in need.  Sometimes this is just being someone who cares and is willing to listen.  Other times this is doing what you can at the moment, and being a bridge until a more experienced, trained professional can intervene. As you talk with the person, try to remember these tips:

• Remind the person that it is normal for people to get overwhelmed and struggle to process things that are going on.
• Be sure to listen and attempt to understand why the person is feeling the way they do. 
• Try and be supportive and encouraging.
• Try to guide them to any solutions for what is troubling them. 
• Talk about friends and family who care about them and who'd be willing to help them.
• Discuss things that the person normally does to cope
• Discuss things that may be triggering to the student and how those can be addressed.
• Bring up past happy moments.  This is especially helpful in situations related to the loss of someone/something.
• Discuss resources available to them both on campus and in the area.

If you believe the person may be a danger to themselves or others, please do the following:

• Survey the room to ensure there aren't any immediate threats, such as a weapon that's easily accessible or empty pill/prescription bottles that may suggest the person has already ingested something.
• Ask the person directly if they are or have been suicidal, or thinking of harming others.  If they say yes, ask on a scale of 1-10 (1-low, 10-high) how suicidal/likely to harm other they are at that moment.  Anything above a 4 should result in a call to the ADRL or DSA on-call.
• Do your best to determine if they have a plan or the means to attempt suicide. If they have the means readily available try and tactfully remove it from the room.
• If the student is not an imminent danger to themselves or others you can encourage them to talk to a faculty/staff member. 
• If the student is a danger to themselves or others, you should refer the student to the Counseling Center and even offer to walk over there with them.
• Should the situation become more than you can handle ask Campus Safety to contact the Student Affairs staff member who’s on-call.
• If the person becomes threatening/violent or you determine that they have already taken steps toward committing suicide (ex. ingested pills, cut themselves, etc.) please contact 911 and Campus Safety immediately. 

After you speak with someone in distress or in crisis always be sure to follow up with your ADRL or ask to speak with the DSA On-Call immediately following a conversation.  This puts the student on our radar and we can help determine if any more immediate actions need to be taken.  This also helps us to start to process with you about how you're doing.  Remember that the campus resources are available to you as well, and you'll need to focus on your own well-being.